Assessing programs designed to improve outcomes for children exposed to violence: Results from nine randomized controlled trials
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The study tests whether participation in interventions offered by a subset of sites from the National Safe Start Promising Approaches for Children Exposed to Violence initiative improved outcomes for children relative to controls.
The study pools data from the nine Safe Start sites that randomized families to intervention and control groups, using a within-site block randomization strategy based on child age at baseline. Caregiver-reported outcomes, assessed at baseline, 6 and 12 months, included caregiver personal problems, caregiver resource problems, parenting stress, child and caregiver victimization, child trauma symptoms, child behavior problems, and social-emotional competence.
Results revealed no measurable intervention impact in intent-to-treat analyses at either 6- or 12-month post-baseline. In 6-month as-treated analyses, a medium to high intervention dose was associated with improvement on two measures of child social-emotional competence: cooperation and assertion. Overall, there is no reliable evidence of significant site-to-site effect variability, even in the two cases of significant intervention effect.
Since families in both the intervention and control groups received some degree of case management and both groups improved over time, it may be advantageous to explore the potential impacts of crisis and case management separately from mental health interventions. It may be that, on average, children in families whose basic needs are being attended to improve substantially on their own.
KeywordsChildren exposed to violence Case management Multi-site evaluations National Safe Start evaluation Violence Victimization
This work was made possible through a grant (2005-JW-BX-0001) from the U.S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention. The opinions expressed here are those of the authors alone. We also appreciate the helpful comments provided by David Weisburd and the anonymous journal reviewers.
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